Coronary Artery Disease

Coronary arteries supply blood to the heart muscle. Like all other tissues in the body, the heart muscle needs oxygen-rich blood to function, and oxygen-depleted blood must be carried away. The coronary arteries run along the outside of the heart and have small branches that supply blood to the heart muscle.

Coronary heart disease, or coronary artery disease (CAD), is characterized by inflammation and the buildup of fatty deposits along the innermost layer of the coronary arteries. The fatty deposits may develop in childhood and continue to thicken and enlarge throughout the life span. This thickening, called atherosclerosis, narrows the arteries and can decrease or block the flow of blood to the heart.

Since coronary arteries deliver blood to the heart muscle, any coronary artery disorder or disease can reduce the flow of oxygen and nutrients to the heart, which may lead to a heart attack and possibly death.

The American Heart Association estimates that over 16 million Americans suffer from coronary artery disease, making it the No. 1 killer of both men and women in the U.S.

Risk Factors

Smoking

High cholesterol

High blood pressure (hypertension)

Physical inactivity

Obesity

High saturated fat diet

Diabetes

Family history

Symptoms

The symptoms of coronary heart disease will depend on the severity of the disease. Some people with CAD have no symptoms, some have episodes of mild chest pain or angina, and some have more severe chest pain.

If too little oxygenated blood reaches the heart, a person will experience chest pain called angina. When the blood supply is completely cut off, the result is a heart attack, and the heart muscle begins to die. Some people may have a heart attack and never recognize the symptoms. This is called a "silent" heart attack.

Symptoms include:

Heaviness, tightness, pressure or pain in the chest behind the breastbone

Pain spreading to the arms, shoulders, jaw, neck or back

Shortness of breath

Weakness and fatigue

Diagnosis

In addition to a complete medical history and physical exam, tests for coronary artery disease may include the following:

Treatment

Treatment options for coronary heart disease include modification of risk factors such as smoking, high cholesterol and blood glucose levels, lack of exercise, poor diet, high blood pressure and weight.

Antihyperlipidemics: These lower lipids (fats) in the blood, particularly low density lipid (LDL) cholesterol. Statins are a group of cholesterol-lowering medicines, and include simvastatin, atorvastatin, and pravastatin, among others. Bile acid sequestrants--colesevelam, cholestyramine and colestipol--and nicotinic acid (niacin) are other medicines used to reduce cholesterol levels.

Antihypertensives: These lower blood pressure. Several different groups of medicines work in different ways to lower blood pressure.